Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13392 | Date 14/08/2025 |
| Token No | SM/25-26/1696 14/08/2025 | Serial | 028 |
| Patient Name | Mrs. NISHA JAISWAL | Contact No | 8100557119 |
| Address | 35/1 PATUA PARA LANE | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||